TN 10 (11-09)

Citations:

CFR §404.506

A. Background and policy for the personal conference decision

If we cannot approve waiver after reviewing the information the individual has given to support his or her contention that the recovery of the overpayment should be waived, offer the individual an opportunity to present his or her case at a personal conference.

The Title II personal conference is conducted by a decisionmaker who was not previously involved in the issues under review (see GN 02270.005.A.2.). The conference is an independent and thorough examination of all evidence relating to the issues under review. The decisionmaker is bound by the requirements of the Social Security Act, the regulations, Social Security Rulings (SSR) and the operating policies and procedures set out in the Program Operations Manual System (POMS) and may not depart from these nationally prescribed policies and procedures.

Following the personal conference issue a written decision to the individual specifying the findings of fact and conclusions in support of the decision to approve or deny waiver and advising of the individual’s right to appeal the decision. Decisionmakers should issue the decision to approve or deny waiver within 2 weeks of the personal conference unless additional evidence is necessary to make the decision and it cannot be obtained within that time.

B. Procedure for making the personal conference decision

1. Consider the evidence

The decisionmaker should do the following:

• Ascertain from the individual if the information presented is correct and the person fully understands it; and

• Allow the individual or their representative to present the individual’s case (see 20 CFR 404.506).

• Be sure the person is aware of all evidence being considered.

Inform the individual if evidence already in file outweighs new evidence introduced at the conference or if additional evidence must be solicited before a decision can be made.

Use any adverse evidence received after the conference only if it was submitted by the individual (or his representative) or the individual has been given the opportunity to review, comment upon, and rebut it. (This is usually done informally, but, if necessary, the conference may be reconvened.)

2. Prepare the decision

Prepare, date, and sign the Waiver Determination (SSA-635) documenting your personal conference decision. For instructions on how to prepare the SSA-635 see GN 02250.315, Documenting the Waiver Determination.

3. Process the decision

Complete the Process Personal Conference (DRPC) screen in the Debt Management System (DMS) after you have conducted the personal conference and have made your decision. For instructions on completing this screen see MSOM DMS 006.009.

Obtain any necessary review per GN 02250.301 before doing any final input or releasing any notice. If the case must go to the Assistant Regional Commissioner, Management and Operations Support (ARC MOS) for review, the final input should not be done until after that review.

4. Prepare the notice

For instructions on preparing the waiver approval or denial notice, see GN 02250.370, Waiver Notice.

5. Notice distribution and document storage

• To determine the level of review for a waiver approval, see GN 02250.301, T2 Waiver Decisionmaker, and release the notice according to the instructions.

• If you have a paper folder, include a copy of the SSA-635 in the folder which is returned to the Program Service Center (PSC).

• Fax a copy of the SSA-635 to the Non-Disability Repository for Evidentiary Documents (NDRed) for viewing in the Claims File User Interface (CFUI) in case something happens to the paper folder while in transit.

• If you have an electronic folder (EF), fax the SSA-635 into the EF. (See Faxing Documents into the Certified Electronic Folder (CEF) Using Barcodes, DI 81010.090)

• Annotate DMS remarks with anything pertinent to the personal conference decision and the date the paper folder was returned to the PSC.

• Store all personal conference notices in the Online Retrieval System (ORS)